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General NPI Number Information
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NPI Number | 1083216915
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Entity Type | Individual
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Provider Name | YUANGUANG XU PHD
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Gender | Male
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 622 W 168TH ST DEPARTMENT OF RADIATION ONCOLOGY
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City | NEW YORK
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State | NY
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Zip | 10032
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Country | US
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Telephone | 212-305-1058
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Fax |
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Provider Business Mailing Address
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Address Line | 143 LEE RD
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City | SCARSDALE
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State | NY
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Zip | 10583-5658
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0205X
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Taxonomy Name | Radiological Physics Physician
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License Number | 000415-1
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License Number State | NY
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